December 17, 2022

Dear PHL friends,

This year, the PHL family was distressed with grief with the passing of doctors John Paar and Harry Adams. They were instrumental to the PHL mission in Nicaragua.


John Paar, the founder of PHL, passed away on September 2nd. He was a remarkable citizen and his involvement to change this world went beyond medicine — he used many platforms to fight against injustice and inequality. Whether he spent his time in a free-clinic in the United States or abroad, worked many hours to collect equipment to be then donated in Nicaragua, volunteered in churches, shelters, orphanages, and even took to the streets to protest the government, he got involved. He would work tirelessly for the ones in need. His energy to work for justice was contagious, and by his example, he inspired everyone.

John believed although we cannot solve all the problems in the world, we can do our part to make this planet a better place. He believed good medical care started with good medical education and training. With the help of friends, John founded PHL to promote the improvement of medical care for the people of Nicaragua. He did this through the education of local health professionals, the acquisition of appropriate medical technology and, when necessary, by direct medical and surgical care, both in Nicaragua and in the United States.

John’s dream was to establish a heart surgery program in Leon led by a local team. He was able to sponsor the training for many Nicaraguan physicians here and abroad to get a complete team to run the cardiac surgery program in Nicaragua. With the help of friends, John equipped the first OR at Hospital Rosales in Leon to be able to perform open heart surgeries there. He also teamed up with colleagues in the United States and Nicaragua to conduct research to document the prevalence of rheumatic heart disease in Nicaragua. Overall, hundreds of patients benefited from lifesaving surgeries because of his work and tenacity.

He did wonderful things here in America and Nicaragua. He would travel miles to rural communities in Nicaragua to deliver life-saving care. He would work long hours in clinics and still do amazing things such as when he used a flashlight to light up the path for the car with broken headlights that took him to a rural clinic. He did this through the passenger window after a long day at work.

I met John early in my career in Nicaragua. The first time I met him, what impressed me the most about him was how he would treat all people with dignity and respect. His sense of humor was exquisite; he would often tease me about slang used here in the US to name marijuana. I could write a book with just stories we shared together in Nicaragua, but rather, I would like to tell you how much he was loved and respected by the people of Nicaragua. I received hundreds of text messages, emails and copies of social media posts expressing solidarity and condolences to his family here.

John changed many people’s lives: his patients, his friends, his colleagues, and even mine too. I learned a lot from John, not only about medicine, but to never give up on dreams — and especially not to give up on Nicaragua. He never did. I learned from him that even doing small things makes a difference. And doing nothing was never an option for John.

Harry Adams joined our mission in 2001, and since then he was a longtime PHL friend and collaborator. He was a key player in the medical student exchange program between East Carolina University and the medical school at UNAN in Leon, Nicaragua. This program allowed medical students from the United States to participate in our mission in Nicaragua, and Nicaraguan students to rotate in hospitals here in America. Harry was involved in selecting candidates, organizing trips, and defining learning objectives for the program, all while rotating abroad and even raising money to pay for student trips. He was a man of many resources, a very organized person that always planned for any kind of circumstances.

A dear friend of mine once commented during a previous trip to Nicaragua: “While some of us just come to Nicaragua on a mission [trip] and have no worries at all, others, like me, worry too much about the mission’s hurdles but take no actions in advance. Harry Adams, on the other hand, always has a plan A and B in place for every potential contingency.”

Besides offering his professional service to the poor people of Nicaragua by delivering medical care, Harry tried to learn and teach medicine for both his fellow citizens and Nicaraguans alike during our mission trips. His last trip to Nicaragua was in 2018, but he continued to be active in many other philanthropist causes.

Harry passed away on September 20th. Our hearts are broken with his departure, and he will be greatly missed.

Dear friends, we must continue the legacy of John Paar, Harry Adams, and many others that, through their contributions and dedication, have made the difference in our communities, both here in the US and in Nicaragua.

PHL continues to work for the poor people of Nicaragua. This year, after so many obstacles from the COVID-19 pandemic, Jeff Brumfield’s group visited Leon and saw 59 patients in clinic and performed 21 procedures. During that trip, pacemakers and defibrillators were implanted for patients in need, and several interventions to treat heart rhythm problems were performed as well. All of this was done in mid-May throughout the span of a single week. Many thanks to Dr. Brumfield and his team for such a superb job.

In late August, we teamed up with Dr. Brumfield to bring a pregnant Nicaraguan patient to the US who needed ablation without the use of X-ray. The patient had life-threatening arrhythmias that needed to be treated before her due date. Her visa and flight expenses were sponsored by both PHL and Dr. Brumfield. The patient was hosted by Dr. Brumfield’s family, and successfully treated at the HCA Florida Largo Hospital by Dr. Brumfield and his team. We are thankful for all of those that helped to make this happen. Dr. Brumfield is planning to return next year and is trying to expand his program by obtaining more equipment for two operating rooms and to perform more interventions to treat heart rhythm problems.

In September, another PHL team visited Leon. This was a small group led by our friend Dr. Elisa Lopez. The objective of the trip was to see patients that were potential candidates for open heart surgeries, hopefully to be performed in September 2023.  A total of 33 patients were seen, and most of them will need surgery. Additionally, we evaluated our equipment and supply assets on the ground for trips in 2023.

Our plan for 2023 is to return in late January or early February to run two clinics to see as many patients as possible. In September, we will return to Nicaragua with a surgical team.

PHL receives no government funding; therefore, our work depends on private donations. Medical equipment, supplies, and shipping are very expensive so, your financial contributions are needed for PHL to continue its mission of helping the people of Nicaragua. We are a 501(C)(3) so your contributions are tax deductible.  There are two ways to contribute:

  • By check made payable to PHL and mailed to the address found in the letterhead.
  • Through our web site:

We value our volunteers, and if interested, submit the volunteer form on our website.  Our volunteers’ documented expenses are also considered a donation to PHL and, therefore, tax deductible. If you would like additional information about serving as a PHL volunteer, please contact at:

On behalf of Project Health for Leon, I would like to thank you for your valuable support.


Carlos A. Espinoza, MD, FACP, President

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